Tuberculosis

Calcific scars, right apex

02/27/2008

Question:

I had my first x-ray last feb. 12 2008. The findings are "Calcific scars, right apex. The rest of the chest structures are within normal limits." Days after I was asked to have a sputum exam. Kindly tell me what does it mean? Am I sick? Is it serious? Is it possible that I have tuberculosis? Can scar be remove? Or will my next x-ray show this scar again?

Answer:

Calcified scars in the lungs may be due to prior fungal or tuberculosis (TB) infection. The lung infection may have been years ago and you recovered without any problem. It is not until a chest x-ray (CXR) is done for another reason that the scar is found.

These scars are usually benign and are not removed. Once you get the scar, it will likely always be there. If you have an old CXR, you may be able to compare to determine if the scar is stable or if it is new since that time. Sometimes your doctor may order a follow-up CXR to make sure it is stable.

To answer your questions, it would be important to know why the CXR was done. Did you have a positive tuberculin skin test? Do you have any risk factors for TB? Do you have a history of exposure to someone with TB, or have you traveled or lived in a TB endemic area? Have you worked with clients that are at risk for TB (hospital, shelter, jail)?

If your tuberculin skin test is positive and you do not have any evidence of active TB disease, then you have Latent TB Infection (LTBI). Your doctor may be ordering additional tests to make sure you do not have any evidence of active TB disease. You should discuss the reasons for the sputum study with your doctor. If you are diagnosed with LTBI, you should be prescribed a medication to prevent you from developing active TB disease.

If you are currently having any symptoms of cough, fever, chills, night sweats, weight loss, or decreased energy level, then you should follow-up with a physician as soon as possible. Sometimes a computerized tomography (CT) scan of the chest may better define areas of abnormality.

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